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Patients who suffer from sight-threatening eye diseases share a desire to regain a comfortable reading ability. In light of the modern advances achieved in ophthalmic diagnosis and therapy, and because a significant lack of comparability between reading charts still exists, there is an increasing need for a worldwide standard in the form of a norm for diagnostic reading charts. Already, applied advancements such as digital print, which allow a calibration of the print sizes of reading charts in correctly progressing geometric proportions by using the actual height of a lower case "x" in millimeters (x-height), and psychophysically standardizing reading charts and their test items by applying modern statistical methods have significantly contributed to establishing a norm for reading charts. In 2020, a proposal of the British delegation was accepted by the International Organization for Standardization (ISO) group "Visual Optics and Optical Instruments," and a working group was established. Bearing in mind the efforts of the ISO with regard to an international norm, this review article is intended to (a) give an overview of the historical background and related normative approaches for diagnostic reading tests used in ophthalmology and optometry, (b) explain psychophysical and technical concerns, and (c) discuss the possibilities and limits of concepts that seem relevant to developing a modern standard for reading charts., Competing Interests: Declaration of competing interest The author receives royalties for the RADNER Reading Charts and the Oculus Reading Probe II. The author has no further affiliation with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript., (Copyright © 2024 The Author. Published by Elsevier Ltd.. All rights reserved.)

Adequate near and intermediate visual capacity is important in performing everyday tasks, especially after the introduction of smartphones and computers in our professional and recreational activities. Primary objective of this study was to review all available reading tests both conventional and digital and explore their integrated characteristics. A systematic review of the recent literature regarding reading charts was performed based on the PubMed, Google Scholar, and Springer databases between February and March 2021. Data from 11 descriptive and 24 comparative studies were included in the present systematic review. Clinical settings are still dominated by conventional printed reading charts; however, the most prevalent of them ( i.e. , Jaeger type charts) are not validated. Reliable reading capacity assessment is done only by those that comply with the International Council of Ophthalmology (ICO) recommendations. Digital reading tests are gaining popularity both in clinical and research settings and are differentiated in standard computer-based applications that require installation either in a computer or a tablet ( e.g. , Advanced VISION Test and web-based ones e.g. , Democritus Digital Acuity Reading Test requires no installation). It is evident that validated digital tests will prevail in future clinical or research settings and it is upon ophthalmologists to select the one most compatible with their examination routine., (International Journal of Ophthalmology Press.)

Purpose: To investigate the effect of font choice on reading parameters by using the RADNER Reading Charts printed in two fonts (Helvetica vs. Times Roman) equalized in terms of x-height., Methods: This is a cross-sectional study of 40 participants with healthy eyes (18 to 60 years of age; mean: 42.13 ± 12.28 years). Reading performance was evaluated binocularly with RADNER Reading Charts printed in either Helvetica Neue (T1) Roman sans serif (Adobe) or Times New Roman PS Roman serif (Adobe). The test distance was 40 cm. Reading charts were presented in random order. Reading acuity (RA), mean reading speed of all sentences read (MEAN-ALL RS), mean reading speed from 0.8 logRAD to 0.3 logRAD (MEAN-RS), maximum reading speed (MAX-RS), and critical print size (CPS) were compared., Results: The RA values obtained for the Helvetica and Times Roman fonts (in full logarithmic units of 0.1 logRAD) did not differ between the two fonts (mean for both fonts: - 0.128 ± 0.064 logRAD; 95% CI for both: - 0.148; - 0.107 logRAD). The differences in all other reading parameters between the two fonts were small and not statistically significant. The analyses revealed narrow confidence intervals and good coefficients of reliability. Except for the CPS (r = 0.49) and RA (equal for Helvetica and Times Roman), the correlations for all parameters were high, ranging from r = 0.92 to r = 0.98., Conclusion: The equivalent reading performance obtained with Helvetica and Times Roman (when equalized in x-height and layout) makes these font types interchangeable as standards for reading charts., (© 2022. The Author(s).)

Purpose: To evaluate microscopically whether the print quality and accuracy of sizing of Landolt ring near vision charts are adequate for the calibration of reading charts., Methods: Near vision charts with Landolt rings from Oculus GmbH (C-Test; Wetzlar, Germany), Precision Vision (Woodstock, IL) and the RADNER Charts were examined, as well as custom-made Landolt rings optimized for print quality. Microscopic investigations and measurements were performed by using a Huvitz HSZ 600 stereomicroscope (Nikon NIS Elements software) to evaluate the height of the Landolt rings, the thickness of the lines, and the width of the openings. The deviations from the mathematically correct values, which were calculated as given in the EN/ISO 8596 and by the International Council of Ophthalmology (ICO), were analyzed (calculated for a test distance of 40 cm)., Results: All the near vision charts showed notable deficiencies in print quality and aberrations from the nominal values in the height, thickness of the lines, and width of the openings. The openings were too narrow, whereas the height and thickness of the lines were larger than the nominal values. Even the openings of Landolt rings optimized for print quality were not always within an acceptable 5% tolerance and need further improvement., Conclusion: This study reports inaccuracies in the heights, thicknesses of the lines, and widths of the openings of Landolt rings in all the near vision charts investigated. The extent of these inaccuracies excludes such near vision charts as reference tests for the calibration of reading charts. The x-height in relation to the visual angle still seems to be the most reliable method for standardizing the print sizes for reading charts., (© 2022. The Author(s).)

Objectives: To compare reading parameters measured with the Turkish version of the Minnesota Low Vision Reading Test (MNREAD-TR) printed acuity chart and the tablet application version of the same test for both normally sighted and low-vision individuals., Materials and Methods: A total of 116 individuals (92 normally sighted and 24 low-vision) were included in the study. All participants were tested with both the print version of the MNREAD-TR chart (method 1) and the tablet application version (method 2). Reading acuity (RA), critical print size (CPS), maximum reading speed (MRS), and reading accessibility index (ACC) were compared statistically., Results: No statistically significant difference was found in RA and CPS between the two methods for the normally sighted individuals (p=0.083 and p=0.075, respectively). There was no statistically significant difference in RA and ACC between the two methods for the patients with low vision (p=0.159 and p=0.103, respectively). The mean MRS was 233.1±34.7 words per minute (wpm) with method 1 and 169.3±23.4 wpm with method 2 in the normally sighted group (p<0.001) and 93.2±50.2 wpm with method 1 and 68.2±34.7 wpm with method 2 in the low-vision group (p<0.001)., Conclusion: In our study, it was found that the parameters RA and CPS in the normally sighted individuals and RA and ACC in the low vision individuals provided similar results in both forms of the MNREAD. The tablet application method can be preferred to eliminate evaluators' bias of scoring the printed chart. In addition, applications have other advantages such as being faster and more practical and providing automatic analysis of parameters, especially in low-vision rehabilitation., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 by Turkish Ophthalmological Association, Turkish Journal of Ophthalmology, published by Galenos Publishing House.)

Clinical Relevance: Measuring reading ability is a crucial part of assessing patients who complain of reduced vision. Foreign language versions of such charts need to be developed and validated., Background: It is difficult to measure or predict Korean reading ability due to a lack of a representative reading charts in Korean, and previous charts have limited capacity to detect deficits in reading ability among Korean patients with eye diseases., Methods: Two printed versions of the reading chart were created. Thirty-four patients with no change in vision in the last three months and no expected change in vision in the next four weeks were included in this study. The results were validated by testing 13 normal-sighted adults (group 1), 14 patients with various macular diseases whose visual acuity was equal or better than 0.5 logarithm of the minimum angle of resolution (logMAR) (group 2), and seven patients with various macular diseases whose visual acuities were between 1.3 logMAR and 0.5 logMAR (group 3). Inter-chart and intra-subject repeatabilities were assessed for maximum reading speed (MRS) and critical print size (CPS)., Results: A total of 38 sentences were tested on 34 adults in three groups. Groups 1 and 2 did not differ significantly in terms of MRS and CPS. The MRS was lower in group 3, for each chart and between visits. The CPS was larger in group 3, for each chart and between visits, with the exception of chart 2 during visit one. With regard to test-retest reliability, the intraclass correlation co-efficients (ICCs) for chart 1 and chart 2 were more than 0.900. With regard to inter-chart reliability, the ICCs were more than 0.892, respectively., Conclusion: The reading chart developed in this study was reliable in producing consistent results among a normal Korean population and patients with various macular diseases.

Purpose: To develop and validate a web-based reading test for normal and low vision patients., Methods: This is a prospective, comparative trial. The web-based Democritus Digital Acuity Reading Test (wDDART) was developed. wDDART introduces a series of advanced characteristics (advanced text calibration, computer-vision-based estimation of patient's distance, and automatic calculation of patient's reading times) that facilitate the overall examination procedure. wDDART's reading parameters [reading acuity (RA), maximum reading speed (MRS), critical print size (CPS) and reading accessibility index (ACC)] were compared to the corresponding ones of its conventional Windows-based reading test (DDART) in a sample of normal and low vision participants. wDDART's test-retest reliability for all reading parameters was evaluated in a 15-day time-window., Results: One hundred patients (normal vision group-NVG: 70; low vision group-LVG: 30 patients) responded to DDART and wDDART. Non-significant differences between the two reading tests were found for all parameters in NVG and LVG. Intraclass correlation coefficients (ICCs) between the two tests demonstrated good or excellent correlation for RA, MRS, ACC and moderate correlation for CPS. Test-retest reliability was excellent for RA and ACC, while ICCs were 0.715-0.895 for MRS and CPS., Conclusion: The wDDART demonstrated sufficient validity and repeatability making it suitable for clinical and research settings., Clinicaltrialsgov Identifier: NCT04618224., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Labiris et al.)

Purpose : The aim of this study was to evaluate the effect of switching treatment in eyes with neovascular age-related macular degeneration (nAMD) and treatment intervals of ≤6 weeks to brolucizumab. Methods : In this prospective series, eyes with persisting retinal fluid under aflibercept or ranibizumab every 4-6 weeks were switched to brolucizumab. Visual acuity (BCVA), reading acuity (RA), treatment intervals, central subfield thickness (CST), and the presence of intra- and subretinal fluid were recorded over 6 months. Results : Seven of 12 eyes completed the 6 month follow-up and received 4.4 ± 0.5 brolucizumab injections within 28.0 ± 2.8 weeks. Treatment intervals increased from 5.3 ± 0.9 weeks to 9.0 ± 2.8 weeks (95% confidence interval of extension (CI): 1.6 to 5.9). BCVA improved from 67.8 ± 7.2 to 72.2 ± 7.5 (95% CI: -0.3 to 9.1) ETDRS letters, RA improved from 0.48 ± 0.15 to 0.31 ± 0.17 LogRAD (95% CI: 0.03 to 0.25), and CST improved from 422.1 ± 97.3 to 353.6 ± 100.9 µm (95% CI: -19.9 to 157.1). Treatment was terminated early in five eyes (two intraocular inflammations with vascular occlusion without vision loss, one stroke, and two changes in the treatment plan). Conclusions : Improvement in visual performance and longer treatment intervals in our series over 6 months indicate the potential of brolucizumab to reduce the treatment burden in nAMD, while two instances of intraocular inflammation were encountered.

Background: MNREAD is an advanced near-vision acuity chart that has already been translated and validated in Greek language. Considering that no validated Greek digital near-vision test exists, our primary objective was to develop and validate a digital near-vision reading test based on the fundamental properties of the Greek printed MNREAD (MNREAD-GR)., Methods: This is a prospective, comparative study. A digital near-vision chart was developed (Democritus Digital Acuity Reading Test - DDART) with text size calibration, audio recording for automatic reading timing, as well as automatic calculation of reading acuity (RA), maximum reading speed (MRS), critical print size (CPS) and reading accessibility index (ACC). Normal and low vision subjects participated in the validation process, responding to MNREAD-GR and DDART at the same day, at a 40 cm viewing distance. Differences in all parameters between the charts were compared with t-test and intraclass correlation coefficients (ICCs). Within 15 days, all participants responded again to DDART in a different set of sentences to assess its test-retest reliability., Results: One hundred patients (normal vision group - NVG: 70 patients; low vision group - LVG: 30 patients) responded to both reading tests. Non-significant differences were detected for all parameters between DDART and MNREAD-GR except for MRS and ACC that were significantly higher in MNREAD-GR in NVG ( p  <  0.01). NVG participants demonstrated sufficient ICCs that ranged from 0.854 to 0.963, while LVG demonstrated ICCs for RA, ACC, MRS and CPS equal to 0.986, 0.894, 0.794 and 0.723, respectively. All parameters calculated with DDART demonstrated excellent test-retest reliability (ICCs: 0.903 - 0.956)., Conclusions: The proposed reading test presented comparable validity and repeatability to MNREAD-GR suggesting that it can be used both in normal and low vision Greek patients., Trial Registration: ClinicalTrials.gov, NCT04242836. Registered 24 January 2020 - Retrospectively registered., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2020.)

Reading is a primary problem for low vision patients and a common functional endpoint for eye disease. However, there is limited agreement on reading assessment methods for clinical outcomes. Many clinical reading tests lack standardized materials for repeated testing and cannot be self-administered, which limit their use for vision rehabilitation monitoring and remote assessment. We compared three different reading assessment methods to address these limitations. Normally sighted participants ( N = 12) completed MNREAD, and two forced-choice reading tests at multiple font sizes in counterbalanced order. In a word identification task, participants indicated whether 5-letter pentagrams, syntactically matched to English, were words or non-words. In a true/false reading task, participants indicated whether four-word sentences presented in RSVP were logically true or false. The reading speed vs. print size data from each experiment were fit by an exponential function with parameters for reading acuity, critical print size and maximum reading speed. In all cases, reading speed increased quickly as an exponential function of text size. Reading speed and critical print size significantly differed across tasks, but not reading acuity. Reading speeds were faster for word/non-word and true/false reading tasks, consistent with the elimination of eye movement load in RSVP but required larger text sizes to achieve those faster reading speeds. These different reading tasks quantify distinct aspects of reading behavior and the preferred assessment method may depend on the goal of intervention. Reading performance is an important clinical endpoint and a key quality of life indicator, however, differences across methods complicate direct comparisons across studies., (Copyright © 2020 Arango, Yu, Lu and Bex.)

Purpose: To develop the Persian version of MNREAD acuity charts and test their repeatability in a normal adult population., Methods: Two hundred sentences were constructed using the most frequent words of 8-year-olds schoolbooks. The number of characters and sentence length were adjusted based on the design principles of the Minnesota Low Vision Reading Test. Two Persian language teachers checked the sentences for syntax and meaning. The accepted sentences were read by 20 adults and then by 20 children. Using RADNER charts method, the sentences with inappropriate reading time and repeated errors were excluded. Thirty-eight sentences were approved to create charts. To check the charts' validity and repeatability, 20 adults read both charts and a paragraph of a daily newspaper. Reading acuity, critical print size, and maximum reading speed were calculated. The measured reading speeds were compared to the readers' reading speeds for a paragraph of a daily newspaper. Bland-Altman plots were used to evaluate the agreement between the two charts., Results: Thirty-eight selected sentences were used in the final printed charts. There were significant correlations between maximum reading speed for Charts 1 and 2 ( r = 0.87, P < 0.0001), Chart 1 and newspaper paragraph ( r = 0.73, P = 0.001), and Chart 2 and newspaper paragraph ( r = 0.83, P = 0.0001). Correlations were observed between reading acuities and critical print sizes of two charts ( r = 0.72, P < 0.002 and r = 0.77, P = 0.00). The 95% limits of agreement in reading acuity, critical print size, and reading speed between Charts 1 and 2 were ± 0.034 logMAR, ±0.11 logMAR, and ±8.00 words per minute, respectively., Conclusion: The designed Persian MNREAD charts are repeatable and could be used reliably to calculate near acuity, reading speed, and critical print size in Persian-speaking people., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Current Ophthalmology.)

Purpose: To assess age-related differences in baseline measures of reading performance obtained from the RADNER Reading Charts in healthy eyes with best corrected (ETDRS) distance acuity., Methods: Cross-sectional study of participants (n=200) aged 25-74 years (n=20 per 5 years age group). Best corrected distance visual acuity was measured monocularly with ETDRS 2000 Charts. Reading performance was evaluated binocularly with the RADNER Reading Charts. Reading acuity (RA), reading acuity score (RA score), mean reading speed (MEAN-RS), maximum reading speed, reading speed with a long paragraph, critical print size (CPS) and the logMAR/logRAD ratio were analysed., Results: RA, RA score, CPS-1 (last logRAD with normal reading speed) and ETDRS acuity did not change significantly between age 25 and 54 years. Overall, the mean RA was -0.091±0.07 logRAD, and the RA score was -0.069±0.07 logRAD. The mean difference between the RA and best ETDRS acuity was 0.0603±0.055 logMAR (r=0.62; p<0.05). The logMAR/logRAD ratio was 87.75%±11.23%. The MEAN-RS ranged from 189±21.9 words per minute (wpm) for the group aged 70-74 years to 236±22.5 wpm for the group aged 40-44 years and correlated well with the long paragraph results (r=0.87)., Conclusion: Best corrected RA, reading speed and ETDRS distance acuity were constant until the age of 54 years. An age-related break point was found between the groups aged 50-54 years and 55-59 years; for reading speed, the break point can be assumed to be within the age range of 50-54 years., Competing Interests: Competing interests: WR receives royalties for the RADNER Reading Charts., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: To investigate the effect of age on reading acuity and reading speed in attaining text information in healthy eyes., Methods: Reading acuity, critical print size, reading speed and maximum reading speed were measured in groups of 40 children (8 to 12 years old), 40 teenagers (13 to 19 years old), 40 young adults (20 to 39 years old), and 40 adults (40 years old and above) using the Buari-Chen Malay Reading Chart [contextual sentences (CS) set and random words (RW) set] in a cross-sectional study design., Results: Reading acuity was significantly improved by 0.04 logMAR for both CS set and RW set from children to teenagers, then gradually worsened from young adults to adults (CS set: 0.06 logMAR; RW set: 0.08 logMAR). Critical print size for children showed a significant improvement in teenagers (CS set: 0.14 logMAR; RW set: 0.07 logMAR), then deteriorated from young adults to adults by 0.09 logMAR only for CS set. Reading speed significantly increased from children to teenagers, [CS set: 46.20 words per minute (wpm); RW set: 42.06 wpm], then stabilized from teenagers to young adults, and significantly reduced from young adults to adults (CS set: 28.58 wpm; RW set: 24.44 wpm). Increment and decrement in maximum reading speed measurement were revealed from children to teenagers (CS set: 39.38 wpm; RW set: 43.38 wpm) and from young adults to adults (CS set: 22.26 wpm; RW set: 26.31 wpm) respectively., Conclusion: The reference of age-related findings in term of acuity and speed of reading should be incorporated in clinical practice to enhance reading assessment among healthy eyes population.

The MNREAD chart consists of standardized sentences printed at 19 sizes in 0.1 logMAR steps. There are 95 sentences distributed across the five English versions of the chart. However, there is a demand for a much larger number of sentences: for clinical research requiring repeated measures, and for new vision tests that use multiple trials at each print size. This paper describes a new sentence generator that has produced over nine million sentences that fit the MNREAD constraints, and demonstrates that reading performance with these new sentences is comparable to that obtained with the original MNREAD sentences. We measured reading performance with the original MNREAD sentences, two sets of our new sentences, and sentences with shuffled word order. Reading-speed versus print-size curves were obtained for each sentence set from 14 readers with normal vision at two levels of blur (intended to simulate acuity loss in low vision) and with unblurred text. We found no significant differences between the new and original sentences in reading acuity and critical print size across all levels of blur. Maximum reading speed was 7% slower with the new sentences than with the original sentences. Shuffled sentences yielded slower maximum reading speeds and larger reading acuities than the other sentences. Overall, measures of reading performance with the new sentences are similar to those obtained with the original MNREAD sentences. Our sentence generator substantially expands the reading materials for clinical research on reading vision using the MNREAD test, and opens up new possibilities for measuring how text parameters affect reading., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

People with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) report vision-related reading difficulty, although this has not been demonstrated objectively. Accordingly, we assessed reading speed and acuity, including crowded acuity and acuity for isolated words using standardized tests of reading and vision, in 27 ME/CFS patients and matched controls. We found that the ME/CFS group exhibited slower maximum reading speed, and had poorer crowded acuity than controls. Moreover, crowded acuity was significantly associated with maximum reading speed, indicating that patients who were more susceptible to visual crowding read more slowly. These findings suggest vision-related reading difficulty belongs to a class of measureable symptoms for ME/CFS patients.

A new generation of logarithmic reading charts has sparked interest in standardized reading performance analyses. Such reading charts have been developed according to the standards of the International Council of Ophthalmology. The print size progression in these calibrated charts is in accordance with the mathematical background of EN ISO 8596. These reading charts are: the Bailey-Lovie Word Reading Chart, the Colenbrander English Continuous Text Near Vision Cards, the Oculus Reading Probe II, the MNREAD Charts, the SKread Charts, and the RADNER Reading Charts. The test items used for these reading charts differ among the charts and are standardized to various extents. The Bailey-Lovie Charts, MNREAD Charts, SKread Charts, and RADNER Charts are also meant to measure reading speed and allow determination of further reading parameters such as reading acuity, reading speed based on reading acuity, critical print size, reading score, and logMAR/logRAD ratio. Such calibrated reading charts have already provided valuable insights into the reading performance of patients in many research studies. They are available in many languages and thus facilitate international communication about near visual performance. In the present review article, the backgrounds of these modern reading charts are presented, and their different levels of test-item standardization are discussed. Clinical research studies are mentioned, and a discussion about the immoderately high number of reading acuity notations is included. Using the logReading Acuity Determination ([logRAD] = reading acuity equivalent of logMAR) measure for research purposes would give reading acuity its own identity as a standardized reading parameter in ophthalmology.

Purpose: To compare the reading time and reading speed measurements obtained with a stopwatch with those of an automated computer program for measuring reading speed and acuity (rad-rd © ; patent: AT 504635B1/10-2006)., Methods: The rad-rd © was used (in conjunction with a PC and microphone) for the computer-based measurements. In rotation, each of four examiners took a turn reading the 12 sentences from one of the four RADNER Reading Charts to three other examiners, who served as stoppers. The stoppers simultaneously measured the reading time with a stopwatch while a fifth investigator used the rad-rd © to obtain computerized measurements. The stopwatch measurements were then statistically compared with the rad-rd © measurements., Results: The mean reading time obtained with the stopwatch measurements was 4.34 ± 0.57 seconds (196.21 ± 21.79 wpm), versus 4.44 ± 0.59 seconds (192.24 ± 22.20 wpm) by computer measurement (r = 0.84). Of the 144 stopwatch measurements, 97 (67.36%) were shorter, and 47 (32.64%) were equal to (n = 5) or longer than the computer measurements. The mean difference for the shorter measurements was -0.17 ± 0.1 seconds (3.91% of the mean reading time), and the mean difference for the longer measurements was 0.11 ± 0.1 seconds (2.53% of the mean reading time). Most differences ranged from -0.1 to 0.1 seconds (42.36%). The results did not differ significantly among the four stoppers., Conclusion: The rad-rd © is an accurate, automated computer program for measuring reading time. Stopwatch measurements, although subject to inaccuracy from several sources, remain a reliable and simple method for analysis of reading performance., (© 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Presbyopia correction is mainly concerned with the goal of regaining an uncorrected reading performance. Since historic reading charts do not provide a unique standard that is applicable for the analysis of clinical and scientific reading performance, new standardized reading charts have been developed, in order to provide reading performance analyses analogous to modern single-optotype distance acuity measurements: the Bailey-Lovie Word Reading Chart, the Colenbrander English Continuous Text Near Vision Cards, the MNREAD Charts, and the RADNER Reading Charts. The last three are also meant to measure reading speed, thus allowing detailed analysis of the reading capabilities of the patient's functional vision. Furthermore, these reading charts can be declared homologated, based on the standards that were published for reading charts by the Visual Function Committee of the International Council of Ophthalmology (ICO) in 1988. Many research studies have shown that by analyzing the reading performance with homologated reading charts, valuable insight into the reading performance of patients suffering from various diseases can be obtained. These reading charts have also been successfully used in presbyopia research. It therefore seems evident that homologated, standardized reading charts facilitate not only research concerning functional vision in many fields of ophthalmology but also international communication about near visual performance. Homologated reading charts are available in almost all languages and have become a valuable tool in analyzing reading performance. We argue in this review that homologated reading charts are clearly a necessity for presbyopia research.

Purpose: To develop 28 short texts to be used as sentence optotypes in a Danish version of the Radner Reading Chart for the measurement of reading acuity and speed., Method: Forty-six short texts of comparable lexical and grammatical difficulty were constructed. The short texts were tested together with two longer reference texts in 100 persons with visual acuity 6/6, of which 50 were university students (age: 24.7 ± 3.1 years, 36% males) and 50 were blue-collar workers (37.2 ± 13.4 years, 54% males). Study parameters were mean reading speed and error rate per participant, and mean reading time, variance and number of errors per short text., Results: The students read the short texts faster than the blue-collar workers (184 ± 21.4 words per minute (wpm) versus 163 ± 26.3 wpm, p < 0.0001). There was a high correlation between the reference texts and the short texts [Pearson's correlation coefficient = 0.89 (95% CI 0.83-0.92)]. The mean reading time for each of the short texts ranged from 4.4 s to 5.8 s with a mean of 4.96 ± 0.35 s, and the median number of errors was eight. Twenty-eight short texts were selected for sentence optotypes with mean reading times between 4.6 s and 5.2 s, a mean standard deviation of 1.2 s or less and a number of errors of 17 per 100 persons or less., Conclusion: Reading time uniformity in the Danish version of the Radner Reading Chart was comparable to that of the original German version. Education had an influence on reading performance that may warrant stratification for this parameter when reading tests are used in clinical trials., (© 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Purpose: To develop a computer-based single sentence reading test especially designed for clinical research enabling multiple repeat trials without reusing the same sentences., Methods: We initially developed 422 sentences, with an average of 60 characters and 12 words. Presentation controls were improved by employing computer-based testing and the oral reading was recorded by visual inspection of digital audio recordings. Variability in reading speed of normally sighted adults between sentences, between charts, between subjects, between formats, and between display devices was quantified. The impact of display size and pixel resolution on test geometry was assessed, and the impact of reduced retinal image quality and retinal illuminance were compared for reading and standard letter acuities. Eleven visually normal subjects (age: 18-60 years) participated in this study., Results: Stopwatch timing of sentences reliably underestimated reading times by about 0.3 s, and exhibited coefficients of repeatability 17 times larger than those estimated from visual inspection of digital recordings. A slight relaxing of the lexical content constraints had no effect on reading speed; neither did sentence format (single vs three lines) or display size or distance. Within subject standard deviations of reading speed for different sentences were small (between 6% and 9% of the mean speed) requiring only small samples sizes to achieve typical statistical reliability and power when comparing conditions within individual subjects. The greater variability associated with stopwatch timing necessitates larger sample sizes. As defocus and light level were varied, reading acuity and standard letter acuity were highly correlated (r(2)  = 0.99), and reading acuity was slightly better., Discussion: A computer-based IURead reading test provides a useful reading speed and reading acuity tool for clinical research involving multiple conditions and repeat testing of individual subjects. Ready to use IURead files for use with a computer, tablet or cell phone can be downloaded from our lab website (https://www.opt.indiana.edu/Bradley/Downloads.aspx)., (© 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.)

Purpose: To develop and validate 28 short Italian sentences for the construction of the Italian version of the Radner Reading Chart to simultaneously measure near visual acuity and reading speed., Methods: 41 sentences were constructed in Italian language, following the procedure defined by Radner, to obtain "sentence optotypes" with comparable structure and with the same lexical and grammatical difficulty. Sentences were statistically selected and used in 211 normal, non-presbyopic, native Italian-speaking persons. The most equally matched sentences in terms of reading speed and number of reading errors were selected. To assess the validity of the reading speed results obtained with the 28 selected short sentences, we compared the reading speed and reading errors with the average obtained by reading two long 4th-grade paragraphs (97 and 90 words) under the same conditions., Results: The overall mean reading speed of the tested persons was 189±26wpm. The 28 sentences more similar in terms of reading times were selected, achieving a coefficient of variation (the relative SD) of 2.2%. The reliability analyses yielded an overall Cronbach's alpha coefficient of 0.98. The correlation between the short sentences and the long paragraph was high (r=0.85, P<0.0001)., Conclusions: The 28 short single Italian sentences optotypes were highly comparable in syntactical structure, number, position, and length of words, lexical difficulty, and reading length. The resulting Italian Radner Reading Chart is precise (high consistency) and practical (short sentences) and therefore useful for research and clinical practice to simultaneously measure near reading acuity and reading speed., (Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.)

Purpose: The purpose of our study was to establish a practical and quick test for assessing reading performance and to statistically analyse interchart and test-retest reliability of a new standardized Swedish reading chart system consisting of three charts constructed according to the principles available in the literature., Methods: Twenty-four subjects with healthy eyes, mean age 65 ± 10 years, were tested binocularly and the reading performance evaluated as reading acuity, critical print size and maximum reading speed. The test charts all consist of 12 short text sentences with a print size ranging from 0.9 to -0.2 logMAR in approximate steps of 0.1 logMAR. Two testing sessions, in two different groups (C1 and C2), were under strict control of luminance and lighting environment. Reading performance tests with chart T1, T2 and T3 were used for evaluation of interchart reliability and test data from a second session 1 month or more apart for the test-retest analysis., Results: The testing of reading performance in adult observers with short sentences of continuous text was quick and practical. The agreement between the tests obtained with the three different test charts was high both within the same test session and at retest., Conclusion: This new Swedish variant of a standardized reading system based on short sentences and logarithmic progression of print size provides reliable measurements of reading performance and preliminary norms in an age group around 65 years. The reading test with three independent reading charts can be useful for clinical studies of reading ability before and after treatment., (© 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Purpose: To evaluate whether visual performance could be improved in pseudophakic subjects by correcting low levels of postoperative astigmatism., Methods: An exploratory, noninterventional study was conducted using subjects who had been implanted with an aspheric intraocular lens and had 0.5-0.75 diopter postoperative astigmatism. Monocular visual performance using full correction was compared with visual performance using spherical equivalent correction. Testing consisted of high- and low-contrast visual acuity, contrast sensitivity, and reading acuity and speed using the Radner Reading Charts., Results: Thirty-eight of 40 subjects completed testing. Visual acuities at three contrast levels (100%, 25%, and 9%) were significantly better using full correction than when using spherical equivalent correction (all P < 0.001). For contrast sensitivity testing under photopic, mesopic, and mesopic with glare conditions, only one out of twelve outcomes demonstrated a significant improvement with full correction compared with spherical equivalent correction (at six cycles per degree under mesopic without glare conditions, P = 0.046). Mean reading speed was numerically faster with full correction across all print sizes, reaching statistical significance at logarithm of the reading acuity determination (logRAD) 0.2, 0.7, and 1.1 (P < 0.05). Statistically significant differences also favored full correction in logRAD score (P = 0.0376), corrected maximum reading speed (P < 0.001), and logarithm of the minimum angle of resolution/logRAD ratio (P < 0.001)., Conclusions: In this study of pseudophakic subjects with low levels of postoperative astigmatism, full correction yielded significantly better reading performance and high- and low-contrast visual acuity than spherical equivalent correction, suggesting that cataractous patients may benefit from surgical correction of low levels of preoperative corneal astigmatism.